CMS Pub. 100-02, ch. 9, § 40.4.1

A hospice may use contracted staff, if necessary, to supplement hospice employees in

order to meet the needs of patients under extraordinary or other non-routine

circumstances.

Arrangements made by a hospice to furnish items or services must be such that receipt of

payment by the hospice for the services relieves the beneficiary of liability or any other

persons to pay for the services. Whether the services and items are furnished by the

hospice itself or by another organization under arrangements made by the hospice, both

must agree not to charge the patient for covered services and items and must agree to

return money incorrectly collected.

A hospice that has a written agreement with another agency, individual, or organization

to furnish any services under arrangement must retain administrative and financial

management, and oversight of staff and services for all arranged services, to ensure the

provision of quality care. Arranged services must be supported by written agreements

that require that all services be--

(1) Authorized by the hospice;

(2) Furnished in a safe and effective manner by qualified personnel; and

(3) Delivered in accordance with the patient's plan of care.